When good skincare isn’t making a difference – what to do?

Dr. Irwin: I am 63 years old and always had good skin- the last few years have been very stressful with the loss of family members and other issues and one day I looked and saw very sun damaged skin (I am Italian with olive skin tone) along with some wrinkles starting on the mid section of my cheeks under my eyes. I had juvederm injections nose to mouth lines and they came out great -- she then did a small amount in the eye area to fill out my face (this didn't work out well) I had very dark color around my eyes and where the needle was injected a small bump formed and I am left with a mark that has darkened. It's been over 2 years since the face injections and I have worked on trying to restore my sundamage and that damage as well. I use retin A .25 mg. at night and I added the SKinmedica TNS serum as well as the skinceuticals CE ferulic serum. I have had some success and my face does look better but it's been a long slow process. My question is should I be increasing the .25 retin A to .5 as the wrinkles that the Derm Doctor was trying to help with the juvederm look much worse than before that injection and I'm only having minimal improvement so far. What do you suggest-- my sun damage is much lighter but I am far from happy with how I look compared to how I use to look. Should I stay the course -- what do you recommend. Your website has been a big help.

You are welcome!   And I think you’re not alone on this because many, many women and men are frustrated with the amount of improvement that they are seeing with various products and procedures in this aesthetic derm arena.

In my opinion, the marketing that these companies do and the expectations they create  are not realistic.   Products are essential for a good base to prevent more damage going forward and can very slightly improve the appearance of the skin.   After about the age of 40ish, they cannot and will not return the skin to it’s former appearance or reverse more serious sun damage.

Here is my current regimen as an example, but yours may be different depending on your skin type.  I’ll post my winter one soon.

At 63, it’s important to consider several things.   The sun damage on the surface can largely be reversed with lasers now – but you will need lasers more like the fractionated CO2 or Fraxel – please see the Topics section under Lasers.

At 63, you will have volume loss which will have changed the shape of your face and to really look quite wonderful again, it needs to be addressed also.   Please do some research and find someone close, if you can, who is very experienced and an expert board certified derm.

Good luck to you!   Dr. I

Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin, and I believe that consumers need and deserve a medically trained and unbiased skincare advocate.

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One of the best investments in your skin is your daily skincare. Why? Because you can prevent many problems with blotchy skin color, lack of glow, texture, some types of acne, and fine lines with good skincare products. You can also correct some of these problems with effective skincare products. Great skincare is often more expensive because quality ingredients are expensive. Some companies spend on research/development which benefits all of us and adds to the cost. Are they worth it? In general - yes!